Prediction, prevention and management of gastroesophageal reflux after per-oral endoscopic myotomy: An update

Figure 2 Conventional and sling fiber preservation technique of per-oral endoscopic myotomy. A: Endoscopic image revealing second penetrating vessel along gastric side. Note that the sling fibers are located towards the left of penetrating vessel; B: Conventional myotomy performed along left side of the penetrating vessel to include sling fibers; C: Completion of conventional myotomy; D: Myotomy along the right side of the penetrating vessel to preserve sling fibers; E: Completion of myotomy (Note the preservation of sling fibers towards the left of second penetrating vessel).